ibuprofen

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ibuprofen

 [i-bu´pro-fen]
a nonsteroidal antiinflammatory drug used as an analgesic and antipyretic and for symptomatic relief of dysmenorrhea, vascular headaches, rheumatoid arthritis, osteoarthritis, and other rheumatic and nonrheumatic inflammatory disorders. It is similar in action to aspirin but less apt to cause gastrointestinal side effects.

ibuprofen

Actiprofen Caplets (CA), Advil, Advil Extra Strength (CA), Advil Migraine, Advil Pediatric Drops, Anadin Ibuprofen (UK), Anadin Ultra (UK), Apo-Ibuprofen (CA), Arthrofen (UK), Brufen (UK), Caldolor, Calprofen (UK), Children's Advil, Children's Motrin, Cuprofen (UK), Extra Strength Motrin IB (CA), Hedex Ibuprofen (UK), Ibugel (UK), Ibuleve (UK), Ibumousse (UK), Ibuspray (UK), Junior Strength Advil, Junior Strength Motrin, Motrin, Motrin IB, Motrin Infant, NeoProfen, Novo-Profen, Nu-Ibuprofen (CA), Nurofen (UK), PMS-Ibuprofen (CA)

Pharmacologic class: Nonsteroidal anti-inflammatory drug (NSAID)

Therapeutic class: Analgesic, antipyretic, anti-inflammatory

Pregnancy risk category B (third trimester: D)

Pregnancy risk category B (third trimester: D)

FDA Box Warning

• Drug may increase risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke. Risk may increase with duration of use, and may be greater in patients who have cardiovascular disease or risk factors for it.

• Drug is contraindicated for perioperative pain in setting of coronary artery bypass graft surgery.

• Drug increases risk of serious GI adverse events, including bleeding, ulcers, and stomach or intestinal perforation, which can be fatal. These events can occur at any time during therapy and without warning. Elderly patients are at greater risk.

Action

Unknown. Thought to inhibit cyclooxygenase, an enzyme needed for prostaglandin synthesis.

Availability

Capsules (liquigels): 200 mg

Injection: 400 mg/4-ml, 800 mg/8-ml vials

Oral suspension: 100 mg/5 ml

Pediatric drops: 50 mg/1.25 ml

Tablets: 100 mg, 200 mg, 400 mg, 600 mg, 800 mg

Tablets (chewable): 50 mg, 100 mg

Indications and dosages

Rheumatoid arthritis; osteoarthritis

Adults: 1.2 to 3.2 g/day P.O. in three to four divided doses

Mild to moderate pain

Adults: 400 mg P.O. q 4 to 6 hours p.r.n. or 400 to 800 mg I.V. over 30 minutes q 6 hours, as necessary

Moderate to severe pain as adjunct to opioid analgesics

Adults: 400 to 800 mg I.V. over 30 minutes q 6 hours, as necessary

Fever reduction

Adults: 400 mg I.V. over 30 minutes, followed by 400 mg P.O. q 4 to 6 hours or 100 to 200 mg P.O. q 4 hours as necessary

Primary dysmenorrhea

Adults: 400 mg P.O. q 4 hours p.r.n.

Juvenile arthritis

Children: 30 to 40 mg/kg/day P.O. in three or four divided doses. Daily dosages above 50 mg/kg aren't recommended.

Fever reduction; pain relief

Children ages 6 to 12: 5 mg/kg P.O. if temperature is below 102.5 °F (39.2 °C) or 10 mg/kg if temperature is above 102.5 °F. Maximum daily dosage is 40 mg/kg.

Off-label uses

• Migraine and tension headaches

Contraindications

• Hypersensitivity to drug or other NSAIDs
• Perioperative use in coronary artery bypass graft surgery

Precautions

Use cautiously in:
• severe cardiovascular, renal, or hepatic disease; GI disease; asthma; chronic alcohol use
• elderly patients
• pregnant (avoid use after 30 weeks' gestation) or breastfeeding patients
• children younger than age 17 (safety and efficacy not established).

Administration

• Ideally, give oral form 1 hour before or 2 hours after meal. If GI upset occurs, give with meals.
• Be aware that patients must be well hydrated before I.V. form is administered.
• Dilute injection form before administering.

Adverse reactions

CNS: headache, dizziness, drowsiness, nervousness, aseptic meningitis

CV: hypertension, arrhythmias

EENT: amblyopia, blurred vision, tinnitus

GI: nausea, vomiting, constipation, dyspepsia, abdominal discomfort, GI bleeding

GU: cystitis, hematuria, azotemia, renal failure

Hematologic: anemia, prolonged bleeding time, aplastic anemia, neutropenia, pancytopenia, thrombocytopenia, leukopenia, agranulocytosis

Hepatic: hepatitis

Metabolic: hyperglycemia, hypoglycemia

Respiratory: bronchospasm

Skin: rash, pruritus, urticaria, Stevens-Johnson syndrome

Other: edema, allergic reactions including anaphylaxis

Interactions

Drug-drug.Antihypertensives, diuretics: decreased efficacy of these drugs

Aspirin and other NSAIDs, corticosteroids: additive adverse GI effects

Cefamandole, cefoperazone, cefotetan, drugs affecting platelet function (including abciximab, clopidogrel, eptifibatide, ticlopidine, tirofiban), plicamycin, thrombolytics, valproic acid, warfarin: increased risk of bleeding

Cyclosporine: increased risk of nephrotoxicity

Digoxin: slightly increased digoxin blood level

Lithium: increased lithium blood level, greater risk of lithium toxicity

Methotrexate: increased risk of methotrexate toxicity

Probenecid: increased risk of ibuprofen toxicity

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, blood urea nitrogen, creatinine, lactate dehydrogenase, potassium: increased values

Bleeding time: prolonged

Creatinine clearance, glucose, hematocrit, hemoglobin, platelets, white blood cells: decreased values

Drug-herbs.Anise, arnica, chamomile, clove, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, licorice: increased risk of bleeding

White willow: additive adverse GI effects

Drug-behaviors.Alcohol use: additive adverse GI effects

Sun exposure: phototoxicity

Patient monitoring

• Monitor for desired effect.
• Watch for GI upset, adverse CNS effects (such as headache and drowsiness), and hypersensitivity reaction.
• Stay alert for GI bleeding and ulcers, especially in long-term therapy.
• In long-term therapy, assess renal and hepatic function regularly.
• Monitor blood pressure closely during treatment.

Patient teaching

• Tell patient to take oral drug with full glass of water, with food, or after meals to minimize GI upset.
• To help prevent esophageal irritation, instruct patient to avoid lying down for 30 to 60 minutes after taking dose.

Instruct patient to immediately report irregular heartbeats, black tarry stools, vision changes, unusual tiredness, yellowing of skin or eyes, change in urination pattern, difficulty breathing, finger or ankle swelling, weight gain, itching, rash, fever, or sore throat.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, alertness, and balance.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

i·bu·pro·fen

(ī'bū-prō'fen),
A nonsteroidal analgesic and anti-inflammatory agent derived from propionic acid.

ibuprofen

/ibu·pro·fen/ (i″bu-pro´fen) a nonsteroidal antiinflammatory drug used in the treatment of pain, fever, dysmenorrhea, osteoarthritis, rheumatoid arthritis, and other rheumatic and nonrheumatic inflammatory disorders, and vascular headaches.

ibuprofen

(ī′byo͞o-prō′fən)
n.
A nonsteroidal anti-inflammatory drug, C13H18O2, commonly used for its analgesic and antipyretic properties.

ibuprofen

[ī′byo̅o̅′prōfin]
a COX-1 over-the-counter nonsteroidal antiinflammatory agent.
indications It is used for the treatment of fever, headaches, and pain from rheumatoid arthritis and osteoarthritis, muscle aches, and menstrual cramps.
contraindications Renal dysfunction, disorders of the GI tract, or known hypersensitivity to this drug, to other nonsteroidal antiinflammatory drugs, or to aspirin prohibits its use.
adverse effects Among the more serious adverse effects are GI disturbances, gastric or duodenal ulceration, dizziness, skin rash, and tinnitus.

ibuprofen

Advil®, Motrin®, Rufen® Therapeutics An OTC oral NSAID tightly bound to albumin, excreted through the kidneys T1/2 2 hrs Indications Headaches, muscle or joint pain associated with anxiety disorders. See NSAIDs.

ibuprofen

A painkilling (analgesic) drug with anti-inflammatory properties, useful in mild rheumatic and muscular disorders and in the relief of menstrual pain. The drug is on the WHO official list. Brand names are Brufen, Fenbid Spansule and Motrin. Brand names of preparations for external use include Deep Relief, Fenbid Gel, Ibugel, Ibuspray and Proflex.

ibuprofen

; Brufen anti-inflammatory, analgesic and antipyretic non-steroidal anti-inflammatory drug (NSAID); fewer side-effects than other non-selective NSAIDs, but has weaker anti-inflammatory properties; adult dose = 1.6-2.4 g daily (for arthritic and musculoskeletal pain); inappropriate for inflammatory conditions (e.g. acute gout); see non-steroidal anti-inflammatory drugs; Table 1
Table 1: The range of side-effects of long-term non-steroidal anti- inflammatory drug (NSAID) medication
SystemEffect
GastrointestinalNausea; dyspepsia; diarrhoea; peptic ulceration or perforation; bleeding
RenalFluid retention; peripheral oedema; renal failure; papillary necrosis; interstitial fibrosis
RespiratoryBronchoconstriction; pulmonary eosinophilia; alveolitis
CoagulationReduced platelet aggregation; increased bleeding time; easy bruising
SkinSevere allergic reactions (e.g. Stevens-Johnson syndrome); toxic epidermal necrolysis; angioedema; skin thinning; reduced healing
VisceralCongestive heart failure; hepatitis; pancreatitis; aseptic meningitis

i·bu·pro·fen

(ī'byū-prō'fen)
Nonsteroidal analgesic and antiinflammatory agent derived from propionic acid.

ibuprofen (ī´būprō´fən),

n brand names: Advil, Excedrin-IB, Midol-IB, Motrin IB;
drug class: nonsteroidal antiinflammatory;
action: inhibits prostaglandin synthesis by interfering with cyclooxgenase needed for biosynthesis; possesses analgesic, antiinflammatory, antipyretic properties;
uses: rheumatoid arthritis, osteoarthritis, mild to moderate pain. Ibuprofen is useful for the temporary relief of minor aches and pains associated with the common cold, toothache, muscular aches, minor arthritic pain, and menstrual cramps and for fever reduction.

ibuprofen

a nonsteroidal anti-inflammatory agent that possesses analgesic and antipyretic activities; used for symptomatic relief of rheumatoid arthritis and osteoarthritis in humans, but its use in dogs is limited by the occurrence of undesirable side-effects such as gastrointestinal hemorrhage.